541 EDMONDS WAY.PDFIIIIIIIIIIIIII
11042
541 EDMONDS WAY
4'. 0
TAX ACCOUNT/PARCEL NUMBER: 22D5Z50c)Z-02,oc-)
BUILDING PERMIT (NEW STRUCTURE): lq5z
COVENANTS (RECORDED)
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $-.
DETERMINATION: [] Conditional Waiver [] Study Required 0 Waiver
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED: -2--92-
SIDE SEWER PERMIT(S) #: (Al Q I
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:,�tO- q(-a5c(%E)
INCE W-01A
LID #:
BLOCK:
LATEMP\DSrs\Fomis\Strcet File Checklist.doc
CITY OF EDMONDS
FOR INSPECTTM Permit 6861
PfjBLIC WORKS DEPAR410T
SI DE SEWER PERMIT 775-2525 Ext. . 220 Issue Date /7 172
k* PERMIT MUST BE POSTED ON JOB SITE * q
7 7o 7 77t wr'umwc 7 Im w . w. `mk�
Address 0 tion 541/
Lj..2. Property Legal Description (include all easements)
LU 3. Single Family Residence P-"' Multi -Family No. of Units
Uj Commercial
cc 4. Owner and/or Builder VIA EDMONDS WAY
I... 26,va4d li'ls>4,�,jv- TRUNK I INE
CO 5. Contractor & License No. 32E_/_ P I ... I
6. Invasion into City Right -of -Way: No P"*_ Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation)
7. Cross other private property: Yes No /--�Easement required -
attach legal description and county easement number.
READ THE FOLLOWI,.NG AND SIGN:
olzi a. Property owners must obtain a permit to install side sewers on
�H their property. A licensed side sewer contractor must be employed to
construct side sewers in the public right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year.
C. Commercial establishment i�equires a minimum of a six inch (6")
side sewer line.
0 d. Side sewers may not be installed closer than thirty inches (30")
to any structure.
0
e. Side sewer lines must be laid at a minimum grade of 2% (1.15
0 and maximum grade of 100% (450). 0
f. No turn in side s8wer greater than 45 (1/8,bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required.
that I have read
DATE:
I �certi
and shall comply with the above
P PERMIT FEE: ';�O 0, 0 Q DISAPPROVED BY: Date:
H 'A' I " -4�'q
ow . By: Date:
CONNECTION FEE:
APPROVED By Date:
PERMIT MUST BE POSTED ON JOB SITE
:j! 6A
SCHEDULE A -00%�
NO. F-99664 AMOUNT $ 21,000.00
DATE may 6, 19(61 at 8:Oo a.m. PREMIUM $ 112-50
1. INSURED
DONALD BROWN and ETHEL M. BROWN, his wife.
2. TITLE TO THE ESTATE, LIEN OR INTEREST INSURED BY THIS POLICY IS VESTED IN
The named insured.
3. ESTATE, LIEN OR INTEREST INSURED
Fee simple estate.
4. DESCRIPTION OF THE REAL ESTATE WITH RESPECT TO WHICH THIS POLICY IS
ISSUED
(a) Part of Sjuthwest quarter of Northwest quarter of Southwest quarter
of Section Twenty-five (25), Township Twenty-seven (27) North.,
Range Three (3) East, d.M., described as follows:
Beginning at the Southeast corner of said subdivision; thence North
88*321 West 125 feet to the true point of beginning; thence North
10001 East 150 feet; thence North 88'321 West 100 feet; thence
South 10001 West 134.69 feet to the Northerly right of way line
of Secondary State Highway No. 1-1d; thence along said riE;ht of
way line, on a curve to the ISt, a radius Of 915-37 feet, off
a tangent bearing South 55014101" East, an arc distance of 28.58
feet; thence South 880321 East 76 feet more or less to the poin-'t
of beginning.
(b) Part of Northwest quarter of Southwest quarterof Southwest quarter
of Section 25, Township 2'T North, Range 3 East, W.M., described
as follows:
Beginning at the Northeast corner of said subdivision, thence North
880321 West 125 feet to the true point of beginning; thence
North 880321 West 55 feet; thence South 20000t East 33.08 feet;
thence North 55048126)" East 52.8o feet to the point of beginning.
EXCEPT any portion thereof within the right of way for Secondary
State Highway No. 1-W.
(C) Part of Southwest quarter of Northwest quarter of Southwest quarter
of Section 25, Township 27 North, Range 3 East, W.M., described
as follows:
Beginning at Southeast corner of said subdivision, thence North
88*321 West 125 feet; thence N�)rth 10001 East 150 feet; thence
North 880321 West 100 feet to the true p61nt of beginning of this
Of
description; thence, from said point of beginning, run South 100
West 134.69 feet; thence North 5058, West 74.24 feet; thence North
9023'53" East 61.66 feet to the point of beginning.
SCHEDULE B
DEFECTS, LIENS, ENCUMBRANCES AND OTHER MATTERS AGAINST WHICH THE COMPANY
DOES NOT INSURE
SPECIAL EXCEPTIONS
1. Local improvement assessments, if any, levied by the municipality
of Edmonds.
_Mortgage dated April 25, 1961, to secure payment of $17.,800.00
-1 in volume 601 of
-,according to not ded April 27, 190'
e; recor
ifiortgages
page 603, under auditor's file No. 14577981 records-*,
f"S"Obomish County, Washington; executed by Donald Brown
Ethel M. Brown, his wife, to Washington Mutual Sa
a Washinpton corT3orp.tinn.
Side Sewer Drawing
The City of Edmonds
EASEMENT NO.
.....................................
NEW CONSTRUCTION Ej REPAIR LID NO . ........... ...... ASMT.'NO.
................
OWNER . ..................................................................... CONTRACTOR 4i.'
. ........................ PERMIT NO.
JOB ADDRESS LOT NO . ...... BLOCK -NO . .....................................
............................................. ... . .......... LEGAL DESCRIPTION .......... ....................
00
......................... ............ .. ..............................................................................
NAME OF ADDITION ......... ........................
A-
0
ax:. 4.
4 ff c- c-
PWW-0001 -.11175 (REV. 11/78)
DATE
By
...................
0
Side Sewer Drawing
The City of Edmonds EASEMENT NO - --------_--_-
702-08150 NEW CONSTRUCTION El REPAIRS M LID NO - ------------------ - ASMT. NO
OWNER -_DONNA ... M. BREIDENSTEIN E
.............. ................ ........................... ..... (RENT R
.............. 4 ------ CONTRACTOR ................................... ........... ------ ............................. PERMIT NO - ---------_---------
JOB ADDRESS ....... 5 ... 4 ... 1. _E_ D_ -M. --- 0 --- N .. D ... S ---- 1--.I.AY
--------- ----------------------- LEGAL DESCRIPTION: LOT NO. .__ ......
--------- -----_-------- BLOCK NO - ------------------- ................
............................................................................................................................................ .....................
NAMEOF ADDITION -------------------------------------------------------------------------------------------------
......................
PWW.DW1-1 1175 (REVA 1178)
DYE TESTED ON SEWER
Approved:
DATE------ - ------- - - ---------_------------- By
...............
City of Edmondle-
RIGHT—OF—AWAYTONSTRUCTION
PERMIT
Permit Number. sos_�
Issue Date: 1,R- -30
A. Address or Vicinity of Construction: 541 Edmonds Way
NJ- GTE to place, opera , ancl maintain a buried vice
--AENF— C) B. Type of Work (be specific): wi re f rom exi sti ng pol e # 1061 1 ocated at 540 Edmonds
9 0- 19 Way then west to a residence at 541 Edmonds Way. GTE to plow 20 feet and push
one road 80 feet. Please see at mCheA q1teinh P Q 11f inn f,-#-i-
Marilyn Holmgren, Permit Coordinator
C. Contractor: GTE Northwest Incbr000ated Contact: Dennis Alexander 771-"9036 mobile �573-1358
2312C W CASINO RD Phone: Marilyn 206/710-0786
Mailing Address: El"ERETT 1.4A 22201t-141,0
State License #: Liability Insurance: Bond: $
D. Building Permit # (if applicable): . Side Sewer Permit # (if applicable):
E. Commercial E] Subdivision F1 City Project E3 Utility (PUD, GTE, WNG,I.CABLE, WATER)
Multi -Family El Single Family Other
2100-9PO.016B 242310
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut 0 Yes 0No G. Size of Cut: 2 twice H� �Q
Pleake se h
P t attac c
A0V&KP;kD AND SIGN 4
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City ofEdmonds harmless from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason �fgranting thisper7nit.
THE CONTRACTOR IS RF
,SPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the a tatementland understand thepermit requirements and thepink copy of thepermit will be
available on site times Hinspection purposes.
Signature: -k— Pi-ohn H. Stowart Date: December 11 � 1996
qec Mgr -Access Design
TOtry Horne
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY.
RIGHT OF WAY DEPOSIT——
TIME AUTHORIZED: VOID AFTER DAYS- DISRUPTION FEE/FUND Ill:
SPECIAL CONDITIONS: -RESTORATION FEE:
PERMIT FEE:
TOTAL FEE: aio
COMMENTS: �RECEIPT FE -
ISSUED BY-
DATM
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
13:45 NO. 148 1703
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